Hilar cholangiocarcinoma is a rare tumor with a poor prognosis.Due to advances in preoperative imaging and enhanced comprehension of tumor biological behavior,surgical management of hilar cholangiocarcinoma has evolved since its original description.Currently,it has been accepted that complete surgical resection provides the only possibility for cure or long-term survival,however,the surgical management of hilar cholangiocarcinoma is extremely challenging because of its anatomical location and vascular proximity.In order to achieve complete resection, several surgical approaches have been investigated and evaluated regarding major hepatic resection,lymph node dissection,vascular resection,extended resection and liver transplantation,however,there are still many disputations. Furthermore,many surgical technical difficulties exist in biliary reconstruction after resection owing to anatomical problems.Focusing on the disputes and problems mentioned above,we herein review and discuss surgical strategies in managing hilar cholangiocarcinoma.

Objective:To investigate the adverse drug reactions ( ADR) caused by carbapenem antibiotics and discuss the influen-cing factors to provide reference for the rational use of carbapenems in clinics. Methods:The ADR caused by carbapenems from March 1, 2008 to August 1, 2014 in our hospital were statistically analyzed. Results:Totally 73 cases of ADR were caused by carbapenems. The number of ADR for men and women was similar. The ADR occurred in 80-year-old people with more frequency. The incidence of ADR on the first day of administration was relative high. The ADR were mainly manifested as skin and appendages disorders and nerve system damage. Conclusion: Great attention should be paid to the ADR of carbapenems and the state of patients. The medication should be adjusted in the patients with declined renal function and nerve system basic diseases in order to reduce the damage of ADR.

10.3969/j.issn.1000-3606.2013.06.023

Objective To study the effect of continuous passive motion (CPM) on hemiplegic patients with shoulder pain.Methods Forty-four patients were divided into a treatment and a control group.Routine stroke treatment was given to the patients in the control group,and CPM was added for patients in the treatment group.A visual analogue scale for pain (VAS) ,Fugl-Meyer(FM) upper extremity motor scale and functional independence measure (FIM) were used to evaluate the results.Results The VAS,FM and FIM scores of both groups improved after treatment,but the VAS results among the treatment group were significantly better than in the control group. Conclusion CPM can be a good treatment for hemiplegie patients with shoulder pain.

Child ; Humans ; Laryngostenosis ; diagnosis ; therapy ; Tracheal Stenosis ; diagnosis ; therapy

Esophageal Diseases ; Humans ; Medicine ; Tracheal Diseases

Objective: To prepare 20(R)-ginsenoside Rg3 selectively and to provide the theory basis for the preparation. Methods: 20(R)-Ginsenoside Rg3 was prepared by hydrolyzing protopanaxadiol (PPD)-type saponins using tartaric acid as the catalyst. The preparation condition was optimized by one-factor experiment and orthogonal test, and the reaction products were analyzed by HPLC. Results: The optimization result of orthogonal test showed that when PPD-type saponins (10 mg/mL) were hydrolyzed by tartaric acid (1.5 mol/L) at 110°C for 2.5 h, all the ginsenosides Rb1, Rc, Rb2, Rb3, and Rd were converted, the yields of 20(R)-ginsenoside Rg3 was 50.15%, and the diastereomer excess percentage (de%) was 93.12%. Conclusion: This method is simple, low-cost, and suitable for the mass production, which is very important to promote the study on the pharmacological activities of 20(R)-ginsenoside Rg3.